Deep Vein Thrombosis (DVT) is a serious risk for travellers.
Whilst it is thought that long haul travel increases the risk of DVT, it is not confined to air travel. The risk increases in proportion to the duration of travel and can be exacerbated by a traveller’s pre-existing medical conditions.
So, what is DVT, how do you know if you’ve got it and what can you do to prevent it? Let’s take a look.
What is it?
Deep Vein Thrombosis is a medical condition where a blood clot (thrombosis) forms in the deep veins of a person’s legs. Prolonged periods of sitting make it difficult for the veins to return the blood to the heart. As a result, blood can pool in the leg veins and this sometimes leads to the formation of a blood clot. Whilst DVT is a serious condition, if part of the blood clot breaks off and travels to the lungs, this can block blood vessels. This condition is known as pulmonary embolism (PE) and is life threatening.
Why does it happen?
Anyone can suffer DVT but if you are travelling for a long period of time, the chances are higher. This is because you are sitting for extended periods of time and in small or confined spaces. When travelling long haul, we typically don’t get up and move around often which further increases the risk.
Pre-existing medial conditions also play a role. Medical conditions known (or suspected) to increase the risk of a person suffering DVT include:
- Cancer – past or current (especially if being treated with chemotherapy)
- Current (or recent) pregnancy
- Previous blood clot or pulmonary embolism
- Family history of blood clots or pulmonary embolism
- Recent surgery, hospitalisation or injury
- Blood clotting disorders
- Congestive heart failure
- Inflammatory bowel disease
- Use of contraceptive pills or hormone replacement therapy which contain estrogen
- Advanced age (the risk increases with a person’s age)
- Impaired mobility
- Varicose veins
What can you do to prevent it?
While travelling, we can all take steps to minimise the risk. If you have any conditions which predispose you to suffering DVT, there are also pre-travel measures you can implement to further safeguard yourself.
While travelling, you can minimise the risk of DVT by:
- Drinking plenty of (non-alcoholic and non-caffeinated) fluids before and during the flight to keep hydrated and prevent your blood from becoming “sticky”.
- Regularly mobilise your ankles / massage, stretch and flex your calf muscles to help your body return blood to your heart. Airlines often have a range of exercises outlined in the inflight magazine or on the safety card. You can find these in the seat pocket.
- If safe to do so, get up and move around the cabin every so often. If possible, choose an aisle seat as this makes it easier for you to be more active during flight.
- Wear loose and non-restrictive clothing and avoid tight underwear.
- Avoid sleeping tablets as they will affect your inflight mobility.
- Use the foot rest to elevate your feet.
If you have a medical condition which increases your risk of suffering DVT, you might like to consider using compression stockings / socks and taking blood thinning medication. Best to check with your doctor to see if these measures are appropriate for you.
What are the symptoms?
Sometimes there are no symptoms.
However, for most people, symptoms include swelling, tenderness and/or pain in the calf of the affected leg. Some people also report red or warm skin in the affected area. If part of the clot has broken away and travelled to the lungs, typical symptoms can include shortness of breath, fast heart rate, coughing up blood, low blood pressure, dizziness, fainting, chest pain and/or collapse.
If you suspect you may have DVT, seek medical attention without unnecessary delay. If you suspect you have pulmonary embolism, urgent medical treatment should be obtained as it is a life threatening condition and can cause sudden death.
How is it diagnosed?
DVT is usually diagnosed by an ultrasound scan of the leg. If the scan (called a duplex ultrasound) is inconclusive, the doctor may order a further test called venography. This test uses an X ray to track the passage of a special dye which is injected into the leg.
What is the treatment?
If the blood clot has not travelled from the leg, treatment usually involves blood thinning medication to prevent the clot from travelling to the lungs. Medication is usually twofold – injection which takes a more immediate effect and tablets which may need to be taken for several months. Your doctor may also recommend the use of compression stockings and leg elevation.
If the blood clot has travelled to the lung, treatment is more exhaustive as doctors will need to support your heart and lung function and perhaps administer pain relief medication in addition to blood thinning medication.
DVT can happen to anyone and if travelling long haul, there are many things we can do to reduce the risk. If you have pre-existing medical conditions which increase your risk, please speak to your doctor before travel to discuss your situation. Also, check with your travel insurer to see if they need to know about your past medical history.